Michelle Scott, PMHNP

Megan O’Brien is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP) with experience in inpatient, outpatient, and emergency mental health settings. She earned her NP degree from UCSF, the top-ranked program in the country at the time. In addition to clinical work, she enjoys teaching and is passionate about training the next generation of compassionate psychiatric nurse practitioners.

Megan believes in meeting patients where they are, offering empathy, respect, and acceptance. She values open communication and sees treatment as a collaborative process. Her approach empowers patients to take the lead in their care while she supports them as a partner and guide along the way.

Megan begins by listening carefully to each patient’s story and asking relevant questions to understand their needs. Together, she and the patient build a tailored treatment plan that aligns with their goals. Her focus is on reducing mental health symptoms and helping people experience greater freedom and flexibility in their lives.

Dr. Tsujimoto-Ryzewski is a board-certified adult psychiatrist. She received her medical degree from the University of Nevada, Reno School of Medicine. She completed her residency at the University of Nevada, Reno School of Medicine, where she served as a chief resident during her last year of training. Dr. Tsujimoto-Ryzewski has treated patients with a wide variety of diagnoses both during her residency and after her training while working at a busy private practice clinic as well as for the Veterans Administration. Dr Tsujimoto-Ryzewski focuses on medication management and supportive psychotherapy. If she feels that additional therapy is needed, she will ask that you bring in a therapist as part of the treatment team. Dr. Tsujimoto-Ryzewski will work collaboratively with you in a caring environment to assist you in reaching your goals.

Darcie Farrell is an ANCC Board Certified Family Psychiatric Nurse Practitioner.  She has worked exclusively in the field of psychiatry during her forty-year nursing career.  She has worked in many care settings, including as a psychiatric Home Health Nurse and as a Certified Case Manager (CCM) in Psychiatry at Blue Cross Blue Shield. During her time at Excellus Blue Cross Blue Shield, she realized the urgent need for psychiatric nurse practitioners, so enrolled in the BSN/MSN program at the University of Rochester, graduating in 2016 with her BSN and in 2018 with her MSN.  She has strong skills and experience in Motivational Interviewing, having worked as a Motivational Counselor for a University of Rochester's Pediatric Research Program.   She has worked for the past seven years as a Nurse Practitioner in Geriatric Outpatient Psychiatry.

Darcie Farrell is a compassionate provider who is client centered. I rely on evidence-based scientific research when determining the best treatment options for clients.  

Darcie Farrell has a very relaxed process for working with patients which allows the client to provide information that is pertinent to their goals for care.  Then, together, we determine which treatment options are likely to be best for the client.

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Dr. Seth Flesher is double board-certified in adult psychiatry and addiction medicine.  Dr. Flesher’s practice focuses on medication management of psychiatric illness without the use of controlled substances.  Typically, he offers this in conjunction with supportive or emotionally focused therapy in 30-minute follow-up visits. However, occasionally Dr. Flesher may believe that additional therapy is also needed and ask that you bring a therapist into your care team to provide the best outcome.

Before joining Talkiatry Dr. Flesher was Medical Director of Advanced Psychiatric Services [complex/high profile cases] at Kings County Hospital and Unit Chief of the Covid19 positive unit.  He was also a clinical professor at Downstate Medical College where he was voted educator of the year numerous times by psychiatric residents and medical students.  Dr. Flesher is a graduate of the prestigious combined 6-year BS/MD program at The Sophie Davis School of Biomedical Education.  He did research at the neuropsychiatric branch of the National Institute of Mental Health, completed his psychiatric residency at St. Lukes/Roosevelt Hospital, and he received his master’s degree in public health from Columbia University.

Dr. Flesher believes that psychiatry should start with a thorough assessment to arrive at an accurate diagnosis.  Then a discussion with the patient of the different evidence-based options available.  Followed by shared decision-making to arrive at an effective treatment plan to achieve the goals that the patient identifies as being important.  This should be done in an honest, open, non-judgmental, but realistic environment.  Understanding that the ultimate goal is to get the patient to a position where they will no longer need medication and/or therapy.

Tiffany Chaille is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP) with nearly a decade of clinical practice and over 15 years of experience working in behavioral health. Her background includes inpatient and outpatient psychiatry, crisis-focused care, community mental health, integrated pain and psychiatry care, and telepsychiatry. She has a growing interest in functional and integrative approaches to mental health. Tiffany earned her Master of Science in Nursing as a PMHNP from Indiana University and her Bachelor of Science in Nursing from Indiana State University.

Tiffany believes mental health care is most effective when patients feel comfortable, supported, and truly heard. She takes a calm, compassionate, and nonjudgmental approach, meeting patients where they are. Her care focuses on practical, real-life treatment plans while considering sleep, stress, medical factors, and lifestyle influences. She values collaboration and aims for patients to feel informed, involved, safe, and confident throughout their care.

Tiffany begins by getting to know the person beyond the symptoms and understanding what brought them to care. She works collaboratively to develop individualized, realistic treatment plans using evidence-based medication management. Ongoing follow-up, thoughtful adjustments, clear communication, and a whole-person approach guide her work, with an emphasis on consistency and long-term support.

Dr. Stephen Geisler is a board-certified adult psychiatrist and has been practicing for over 37 years. His practice focuses on medication management, and typically offers this in conjunction with supportive therapy in 30-minute follow-up visits. If Dr. Geisler feels you would benefit from working with a therapist in conjunction with medication management, he welcomes collaboration with your therapist to make for the best outcome. Dr. Geisler is a graduate of the New York University School of Medicine. He completed a fellowship in Psychoanalytic Psychotherapy at the Zucker Hillside Hospital of Northwell Health after finishing his residency training there. He is currently an Assistant Clinical Professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. Over the years Dr. Geisler has received a number of awards including NAMI Exemplary Psychiatrist Award, The APA Irma Bland Certificate of Excellence in Teaching Residents, the Zucker Hillside Hospital Department of Psychiatry Recognition Award for Education, and twice received the Outstanding Teacher of the Year Award from the graduating residents' class. Dr. Geisler is a member of the American Psychiatric Association, the Nassau Suffolk District Branch of the APA and the American Society of Clinical Psychopharmacology. Through the years, Dr. Geisler has participated in many clinical research projects, has been the co-author of many papers, and has made many presentations. Dr. Geisler specializes in psychopharmacology, especially tailoring individualized treatment to serve the needs of patients with a variety of conditions. He has a lot of experience in treating patients with depression, bipolar disorder, anxiety disorders, ADHD, and OCD.